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Reference ranges and determinants of thyroid function during early pregnancy: the SELMA study
Academic Center for Thyroid Diseases, Erasmus MC, Rotterdam, The Netherlands; Department of internal Medicine, Erasmus MC, Rotterdam, The Netherlands.
Department of Environmental Science and Analytical Chemistry, Stockholm University, Stockholm, Sweden.
Laboratory of Clinical Chemistry and Haematology, Máxima Medical Centre, Veldhoven, De Run, The Netherlands.
Laboratory of Clinical Chemistry and Haematology, Máxima Medical Centre, Veldhoven, De Run, The Netherlands.
Vise andre og tillknytning
2018 (engelsk)Inngår i: Journal of Clinical Endocrinology and Metabolism, ISSN 0021-972X, E-ISSN 1945-7197, Vol. 103, nr 9, s. 3548-3556Artikkel i tidsskrift (Fagfellevurdert) Published
Abstract [en]

Context: Establishing reference ranges as well as identifying and quantifying the determinants of thyroid function during pregnancy is important for proper clinical interpretation and optimizing research efforts. However, such data are sparse, specifically for (F)T3 measurements and most studies do not take into account thyroid antibodies or hCG.

Objective: To determine reference ranges and to identify/quantify determinants of TSH, FT4, FT3, TT4 and TT3.

Design, Setting and Participants: This study included 2,314 participants of the Swedish Environmental Longitudinal, Mother and child, Asthma and allergy study, a population-based prospective pregnancy cohort of mother-child pairs. Reference ranges were calculated by 2.5-97.5th percentiles after excluding TPOAb and/or TgAb positive women.

Intervention: None.

Main Outcome Measures: TSH, FT4, FT3, TT4 and TT3 in prenatal serum.

Results: After exclusion of TPOAb positive women, reference range were: TSH: 0.11-3.48 mU/L, FT4: 11.6-19.4 pmol/L, FT3: 3.72-5.92 pg/mL, TT4: 82.4-166.2 pmol/L and TT3: 1.28-2.92 nmol/L. Additional exclusion of TgAb positive women did not change the reference ranges substantially. Exposure to tobacco smoke, as assessed by questionnaires and serum cotinine, was associated with lower TSH and higher FT3 and TT3. BMI and gestational age were the main determinants of TSH (only for BMI), FT4, FT3, TT4 and TT3.

Conclusions: We show that the exclusion of TgAb positive women on top of excluding TPOAb positive women hardly affects clinical reference ranges. We identified various relevant clinical determinants of TSH, FT4, FT3, TT4 and TT3 which could reflect endocrine disrupting effects and/or effects on thyroid hormone transport or deiodination.

sted, utgiver, år, opplag, sider
Oxford University Press, 2018. Vol. 103, nr 9, s. 3548-3556
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Identifikatorer
URN: urn:nbn:se:oru:diva-68366DOI: 10.1210/jc.2018-00890ISI: 000444322000052PubMedID: 29982605OAI: oai:DiVA.org:oru-68366DiVA, id: diva2:1238476
Forskningsfinansiär
Swedish Research Council Formas
Merknad

Funding Agencies:

Exchange in Endocrinology Expertise (3E) program of the European Union of Medical Specialists (UEMS), Section and Board of Endocrinology  

ZOnMW VIDI  016.176.331 

Erasmus MC MRACE grant  

County Council of Värmland, Sweden 

Tilgjengelig fra: 2018-08-13 Laget: 2018-08-13 Sist oppdatert: 2018-10-04bibliografisk kontrollert

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